Basilar tip thromboembolism

Case contributed by A.Prof Frank Gaillard

Presentation

Sudden onset of loss of consciousness.

Patient Data

Age: 60 years
Gender: Male
CT

The tip of the basilar artery is markedly hyperdense and there appears to be low density involving the central midbrain and right cerebral peduncle. 

CT

CT angiogram confirms the presence of a filling defect at the tip of the basilar artery. The left superior cerebellar and both posterior cerebral arteries are opacified with contrast. The right SCA is occluded. 

Case Discussion

Typical appearances of a basilar tip thromboembolism. Despite endovascular thrombolysis and attempted clot retrieval (which was moderately angiographically effective (not shown)), the patient did not recover consciousness and developed extensive infarction, and eventually passed away. 

Note: Top of basilar occlusion is usually embolic, whereas mid-basilar occlusion is usually the result of in situ thrombosis as a result of atherosclerotic plaque complication. 

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Case information

rID: 19199
Case created: 16th Aug 2012
Last edited: 7th Jan 2016
Inclusion in quiz mode: Included

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